Patients aged over 60 who lose weight 'should be tested for cancer'
Weight loss in patients over the age of 60 should be urgently investigated, with one in seven cases among men likely to mean cancer, a major study has found.
The research by Oxford University found that losing weight is the key symptom of the disease, linked to at least 10 types of cancer.
Experts called on GPs to refer patients with unexplained weight loss for urgent tests, in a bid to speed up diagnosis.
Britain’s survival rates are lagging behind may comparative countries, with the UK falling in the bottom half of international league tables for seven major forms of the disease.
Unexplained weight loss has long been associated with cancer.
But Tuesday’s research, involving more than 11 million patients, is the first major study to quantify the association.
Overall it found that among those over 60, men with unintended weight loss had a 14.2 per cent risk of cancer, with a 6.7 per cent risk found among women of the same age.
Experts said the higher rate among men was found because weight loss was closely linked to prostate cancer, the most common cancer in men.
The facts | Prostate cancer
Lead author Dr Brian Nicholson, of the University of Oxford, said GPs needed to be able to refer patients to centres which could check for several cancers at once, in order to make the right diagnosis quickly.
Last week health officials announced plans to test such an approach in 10 parts of the country.
Dr Nicholson said: “Streamlined services that allow GPs to investigate non-specific symptoms like weight loss are vitally important and urgently needed if we are to catch cancer earlier and save lives.”
He said more research was needed to establish the amount of weight loss which constituted grounds for concern.
“Our research indicates that coordinated investigation across multiple body sites could help to speed up cancer diagnosis in patients with weight loss,” he said.
“We now need to continue our research to understand the most appropriate combination of tests and to give guidance on how much weight loss GPs and patients should worry about.”
We’ve always known that unplanned weight loss may represent cancer
Professor Willie Hamilton, study co-author
Leading GPs said patient access to tests for cancer was among the lowest in Europe
A team led by the Universities of Oxford and Exeter examined 25 studies, involving 11.5 million patients.
Their study, funded by the National Institute for Health Research and published in the British Journal of General Practice, found that unintended weight loss was the second highest risk factor for colorectal, lung, pancreatic and renal cancers.
The only symptoms found to be more common were those linked to specific cancers, such as rectal bleeding, for bowel cancer, and jaundice for pancreatic disease.
Co-author Professor Willie Hamilton, from the University of Exeter, said: “We’ve always known that unplanned weight loss may represent cancer. This study pulls together all the published evidence and demonstrates beyond doubt that it is important in efforts to save lives from cancer.”
Everything you need to know about prostate cancer but were too afraid to Google
Dr Richard Roope, clinical lead for cancer at the Royal College of GPs, said: "Currently there are no clinical guidelines to support GPs and their teams in how to respond to or investigate patients who present with weight loss, without other symptoms, in the cancer setting.
"These important findings present strong evidence of the correlation between significant unexplained weight loss and many cancers, and should certainly be taken on board as clinical guidelines for GPs and healthcare professionals are updated and developed.
"We agree with the researchers' recommendations that GPs need better access to diagnostic tools in the community across the UK so that we can appropriately refer patients to either rule out or confirm a diagnosis of cancer, as currently our access is among the lowest in Europe."
A spokesperson for NHS England said: “Rapid and accurate diagnosis is vital for all cancers. Patients are now being tested sooner with investment in greater diagnostic capacity including in one-stop cancer diagnostic services across the country.
"These new one-stop-shops represent a real step change in the way people with unclear symptoms such as unexplained weight loss, appetite loss or abdominal pain are identified, diagnosed and treated.”
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